Individual
DR. MICHAEL MANAKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2421 LAPORTE AVE, VALPARAISO, IN 46383-6914
(219) 462-6192
(219) 464-2585
Mailing address
1040 SIERRA DR, SUITE 400, GREENWOOD, IN 46143-7241
(317) 528-4284
(317) 865-8355
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02000642
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000721918
ANTHEM TRADITIONAL
IN
05
—
100434540
—
IN
Enumeration date
07/01/2005
Last updated
05/02/2013
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